Galen NUR 242 – Exam 2
Medical-Surgical Nursing
Comprehensive Study Guide & Mock Exam 2026
, 1. A nurse is caring for four clients on a medical-surgical unit. Which client should the nurse
assess first using clinical judgment and prioritization frameworks?
A. A client with chronic heart failure reporting 2+ bilateral lower extremity edema
B. A client 8 hours post–cardiac catheterization with a small amount of bruising at the
insertion site
C. A client with pneumonia and oxygen saturation of 86% on 2 L nasal cannula
D. A client with type 2 diabetes reporting a blood glucose of 240 mg/dL
Correct answer is C
2. A client 24 hours post-thyroidectomy reports tingling around the lips and fingers. Which
action should the nurse take first?
A. Assess the surgical site for bleeding
B. Check the client’s serum calcium level
C. Prepare to administer IV potassium
D. Reposition the client in high-Fowler’s position
Correct answer is B
3. A nurse delegates ambulation of a stable postoperative client to an unlicensed assistive
personnel (UAP). Which instruction is most appropriate to ensure safe delegation?
A. “Assist the client to walk twice during your shift.”
B. “Walk the client and report any shortness of breath or dizziness immediately.”
C. “Let me know if you have time to walk the client.”
D. “Document the ambulation in the chart.”
Correct answer is B
4. A client with sepsis has BP 82/48 mmHg, HR 128 bpm, RR 28/min, and lactate 4
mmol/L. Which prescription should the nurse implement first?
A. Administer IV broad-spectrum antibiotics
B. Obtain blood cultures
C. Initiate rapid IV fluid resuscitation
D. Apply cooling blanket
Correct answer is C
5. A nurse discovers a colleague documenting medications that were not administered.
What is the nurse’s priority action?
A. Ignore the situation
B. Confront the colleague privately and take no further action
C. Report the incident to the nurse manager
D. Discuss concerns with other staff members
, Correct answer is C
6. A client with COPD becomes increasingly restless and confused. Oxygen saturation is
89% on 2 L nasal cannula. What is the nurse’s priority action?
A. Increase oxygen to 6 L via nasal cannula
B. Encourage coughing and deep breathing
C. Assess for signs of carbon dioxide retention
D. Place the client in supine position
Correct answer is C
7. A nurse is caring for a client with hyperkalemia (K+ 6.4 mEq/L). Which ECG finding is
expected?
A. Prolonged QT interval
B. Peaked T waves
C. ST-segment depression
D. U waves
Correct answer is B
8. Which client is appropriate for assignment to a newly licensed RN?
A. A client requiring titration of IV vasopressors
B. A client with unstable angina and active chest pain
C. A client 48 hours post-appendectomy with stable vital signs
D. A client with acute GI bleeding
Correct answer is C
9. A nurse is caring for a client who suddenly develops unilateral weakness and slurred
speech. What is the priority action?
A. Obtain a blood glucose level
B. Elevate the head of bed
C. Call a rapid response or stroke alert
D. Document the findings
Correct answer is C
10.A client with heart failure reports a 4-pound weight gain in 2 days and increased
dyspnea. Which intervention is priority?
A. Encourage oral fluids
B. Assess lung sounds and oxygen saturation
C. Document as expected finding
D. Reduce sodium intake
Correct answer is B
Medical-Surgical Nursing
Comprehensive Study Guide & Mock Exam 2026
, 1. A nurse is caring for four clients on a medical-surgical unit. Which client should the nurse
assess first using clinical judgment and prioritization frameworks?
A. A client with chronic heart failure reporting 2+ bilateral lower extremity edema
B. A client 8 hours post–cardiac catheterization with a small amount of bruising at the
insertion site
C. A client with pneumonia and oxygen saturation of 86% on 2 L nasal cannula
D. A client with type 2 diabetes reporting a blood glucose of 240 mg/dL
Correct answer is C
2. A client 24 hours post-thyroidectomy reports tingling around the lips and fingers. Which
action should the nurse take first?
A. Assess the surgical site for bleeding
B. Check the client’s serum calcium level
C. Prepare to administer IV potassium
D. Reposition the client in high-Fowler’s position
Correct answer is B
3. A nurse delegates ambulation of a stable postoperative client to an unlicensed assistive
personnel (UAP). Which instruction is most appropriate to ensure safe delegation?
A. “Assist the client to walk twice during your shift.”
B. “Walk the client and report any shortness of breath or dizziness immediately.”
C. “Let me know if you have time to walk the client.”
D. “Document the ambulation in the chart.”
Correct answer is B
4. A client with sepsis has BP 82/48 mmHg, HR 128 bpm, RR 28/min, and lactate 4
mmol/L. Which prescription should the nurse implement first?
A. Administer IV broad-spectrum antibiotics
B. Obtain blood cultures
C. Initiate rapid IV fluid resuscitation
D. Apply cooling blanket
Correct answer is C
5. A nurse discovers a colleague documenting medications that were not administered.
What is the nurse’s priority action?
A. Ignore the situation
B. Confront the colleague privately and take no further action
C. Report the incident to the nurse manager
D. Discuss concerns with other staff members
, Correct answer is C
6. A client with COPD becomes increasingly restless and confused. Oxygen saturation is
89% on 2 L nasal cannula. What is the nurse’s priority action?
A. Increase oxygen to 6 L via nasal cannula
B. Encourage coughing and deep breathing
C. Assess for signs of carbon dioxide retention
D. Place the client in supine position
Correct answer is C
7. A nurse is caring for a client with hyperkalemia (K+ 6.4 mEq/L). Which ECG finding is
expected?
A. Prolonged QT interval
B. Peaked T waves
C. ST-segment depression
D. U waves
Correct answer is B
8. Which client is appropriate for assignment to a newly licensed RN?
A. A client requiring titration of IV vasopressors
B. A client with unstable angina and active chest pain
C. A client 48 hours post-appendectomy with stable vital signs
D. A client with acute GI bleeding
Correct answer is C
9. A nurse is caring for a client who suddenly develops unilateral weakness and slurred
speech. What is the priority action?
A. Obtain a blood glucose level
B. Elevate the head of bed
C. Call a rapid response or stroke alert
D. Document the findings
Correct answer is C
10.A client with heart failure reports a 4-pound weight gain in 2 days and increased
dyspnea. Which intervention is priority?
A. Encourage oral fluids
B. Assess lung sounds and oxygen saturation
C. Document as expected finding
D. Reduce sodium intake
Correct answer is B
